Chronic Back Pain

Chronic back pain occurs when back pain lasts more than three months. At times, the pain may become more severe.

Most low back pain cannot be pin pointed to a specific cause. However, we can categorize back conditions into three groups.

• Non specific low back pain – 85% of patients presenting to primary care doctors for low back pain cannot be attributed to a specific disease or spinal abnormality.
• Back pain associated with radiculopathy (symptoms travelling down the leg) or spinal stenosis (narrowing of the spinal canal). This is leg pain that is often associated with a herniated disc or spinal stenosis.
• Back pain potentially associated with another specific cause. This is back pain associated with cancers, compression fractures, spinal infections and inflammatory conditions such as ankylosing spondylitis.

• For non specific low back pain, as the name suggests there may be no specific cause.
• Sometimes back pain can gradually come on.
• This may be related to sustained postures or repetitive spine movements.
  • In some cases there may have been an incident that caused injury to the back.
• Back pain with radiculopathy is often caused by a disc herniation.
• Risk factors for disc injury could include too much bending, lifting too heavy a weight and/or twisting movements.
• Spinal stenosis is often due to age related changes.
• Back problems associated with serious diseases are termed “red flag” symptoms.
  • These include fevers and chills, night sweats, unexplained weight loss, pain worsening at night or at rest, history of cancer, use of immunosuppressant medications, needle drug use and recent bacterial infections

• Non-specific or mechanical back pain is usually managed with
  • Strengthening exercise, self-stretches, comfort positions, limiting irritating postures, pain medications, and injection therapy
• Sometimes it is helpful to be supervised by a physiotherapist or chiropractor.
• It is common for psychological or emotional factors to be present in chronic low back pain, for which counselling may be helpful.

• You become extremely weak
• You develop balance issues
• You begin to experience new symptoms

• Symptoms associated with Cauda Equina Syndrome include the following:
  • Inability to urinate followed by overflow incontinence, meaning you cannot pee but urine trickles out after your bladder has filled up.
  • Loss of bowel control, meaning you had a bowel movement and didn’t realize it occurred.
  • Numbness in the genital or anal region, meaning you have lost feeling there and cannot feel yourself urinating or cannot feel when you wipe yourself.

**If you experience any combination of these symptoms, please go to your nearest emergency department

Bone and Joint Canada